Comparison of the effects of phenobarbitone and morphine administration on EEG activity in preterm babies

Bell, Angela H.; Greisen, Gorm; Pryds, Ole

doi:10.1111/j.1651-2227.1993.tb12511.x

Cited by 88 publications

(52 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, most infants in these studies were severely ill, required ventilation at the time of the recording, and had received phenobarbitone, which may have caused increased aEEG discontinuity. 23 By contrast, the infants in the current study were neurologically normal and clinically stable at the time of the recording and had not received any sedative medication. Therefore, the results of the current study are most reliable.…”

Section: Discussionmentioning

confidence: 65%

Reference Values for Amplitude-Integrated Electroencephalographic Activity in Preterm Infants Younger Than 30 Weeks’ Gestational Age

et al. 2004

View full text Add to dashboard Cite

ABSTRACT. Objective. To prospectively investigate the development of amplitude-integrated electroencephalographic (aEEG) activity during the first 2 weeks of life in neurologically normal and clinically stable preterm infants <30 weeks' gestational age (GA).Patients and Methods. Infants with a GA of <30 weeks admitted to the neonatal intensive care unit of the Vienna University Children's Hospital (Vienna, Austria) were studied prospectively by using aEEG and cranial ultrasound. Clinically stable infants without clinical or sonographic evidence of neurologic abnormalities were eligible for inclusion in the reference group. The distribution of 3 background aEEG activity patterns (discontinuous low-voltage, discontinuous high-voltage, and continuous), presence of sleep-wake cycles, and number of bursts per hour in the reference group were determined by visual analysis.Results. Seventy-five infants (median GA: 27 weeks; range: 23-29 weeks) were eligible for inclusion in the reference group and had aEEG recordings during the first 2 weeks of life available. Analysis of aEEG background activity showed that with higher GA the relative amount of continuous activity increased while discontinuous patterns decreased. The number of bursts per hour decreased with increasing GA. Cyclical changes in aEEG background activity resembling early sleep-wake cycles were observed in all infants.Conclusions. Normal values for aEEG background activity were determined in preterm infants <30 weeks' GA. Clinically stable and neurologically normal preterm infants exhibit at least 2 different patterns of aEEG activity. There is a correlation between the GA and the relative duration of continuous aEEG activity. A dvances in neonatal intensive care during the last decades have led to an increased survival rate of extremely low birth weight infants. However, neurologic and developmental disability is still common among survivors. 1 Prevention of brain injury in these patients has become one of the main goals of modern neonatology. Continuous monitoring of neonatal brain function may aid in the identification of risk factors and patients at increased risk for neurologic morbidity. Early recognition and modification of potentially harmful environmental factors may prevent secondary brain injury.Conventional electroencephalography (EEG) is one of the most useful tools for intermittent and continuous assessment of brain function and prediction of neurologic outcome in term infants and children. 2-4 However, conventional EEG has limitations in its application for extremely low birth weight infants. Registration and interpretation of conventional EEG in this age group are difficult because of the electrical interferences on the neonatal intensive care unit, the large volume of data generated during a longer recording, and the need for 24-hour availability of a skilled examiner experienced in EEG of preterm infants. Further, data on normal EEG patterns in extremely premature infants are still limited. 5,6 Recently, amplitude-integrated EEG (aEEG) pro...

show abstract

Section: Discussionmentioning

confidence: 65%

Reference Values for Amplitude-Integrated Electroencephalographic Activity in Preterm Infants Younger Than 30 Weeks’ Gestational Age

et al. 2004

View full text Add to dashboard Cite

show abstract

“…The background pattern is beginning to show signs of improvement from around 12:11. . (20). The patients in our study recovered to a normal continuous background pattern with SWC even when still treated with continuous i.v.…”

Section: Discussionmentioning

confidence: 72%

Effect of Sedation and Analgesia on Postoperative Amplitude-Integrated EEG in Newborn Cardiac Patients

et al. 2010

View full text Add to dashboard Cite

ABSTRACT:The aim of this study is to describe the effect of sedation and analgesia on postoperative amplitude-integrated EEG (aEEG) in newborns with congenital heart disease (CHD) undergoing heart surgery. This is a consecutive series of 26 newborns with CHD of which 16 patients underwent cardiopulmonary bypass (CPB) surgery and 10 patients did not. aEEG was monitored for at least 12 h preoperatively and started within the first 6 h postoperatively for 48 h. Outcome was assessed at 1 year of age. All 26 patients showed a normal preoperative continuous cerebral activity with sleep-wake cycles (SWC). The postoperative duration to return to normal background activity with SWC was similar for both groups. Independent of group assignment, patients requiring midazolam had a significantly later onset of a normal SWC than those without midazolam (p ϭ 0.03). Three patients in the CPB group and two in the non-CPB group showed continuous low voltage or flat trace after administration of fentanyl. These changes did not correlate with neurodevelopmental outcome. Sedation with midazolam has a transient effect on the background activity, whereas fentanyl can induce a severe pathologic background pattern. The significance of these changes on outcome is not yet clear. Thus, more attention should be paid to these effects when interpreting aEEG in this population. (Pediatr Res 67: 650-655, 2010)

show abstract

“…48 Standard phenobarbitone loading doses (10 to 20 mg∕kg only moderately affect the EEG background activity in full term infants. However, evidence suggests that the more severe the hypoxic ischemic insult, the more easily phenobarbitone can induce EEG discontinuity or BS.…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic response to burst-suppressed and discontinuous electroencephalography activity in infants with hypoxic ischemic encephalopathy

et al. 2016

View full text Add to dashboard Cite

Abstract. Burst suppression (BS) is an electroencephalographic state associated with a profound inactivation of the brain. BS and pathological discontinuous electroencephalography (EEG) are often observed in term-age infants with neurological injury and can be indicative of a poor outcome and lifelong disability. Little is known about the neurophysiological mechanisms of BS or how the condition relates to the functional state of the neonatal brain. We used simultaneous EEG and diffuse optical tomography (DOT) to investigate whether bursts of EEG activity in infants with hypoxic ischemic encephalopathy are associated with an observable cerebral hemodynamic response. We were able to identify significant changes in concentration of both oxy and deoxyhemoglobin that are temporally correlated with EEG bursts and present a relatively consistent morphology across six infants. Furthermore, DOT reveals patient-specific spatial distributions of this hemodynamic response that may be indicative of a complex pattern of cortical activation underlying discontinuous EEG activity that is not readily apparent in scalp EEG.

show abstract

Comparison of the effects of phenobarbitone and morphine administration on EEG activity in preterm babies

Cited by 88 publications

References 17 publications

Reference Values for Amplitude-Integrated Electroencephalographic Activity in Preterm Infants Younger Than 30 Weeks’ Gestational Age

Reference Values for Amplitude-Integrated Electroencephalographic Activity in Preterm Infants Younger Than 30 Weeks’ Gestational Age

Effect of Sedation and Analgesia on Postoperative Amplitude-Integrated EEG in Newborn Cardiac Patients

Hemodynamic response to burst-suppressed and discontinuous electroencephalography activity in infants with hypoxic ischemic encephalopathy

Contact Info

Product

Resources

About